Laparoscopic T-tube Placement After Common Bile Duct Exploration: A Simple Technique

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IntroductionLaparoscopic T-tube insertion into common bile duct (CBD) can be technically challenging. We describe a technique to facilitate CBD T-tube placement.MethodThe T-limb was cut to appropriate size and guttered along one-third of its circumference lengthwise. One end of T-limb was secured to the long stem using a tie. The free end was introduced into the abdomen through the epigastric port. Using nontraumatic graspers, this free end was advanced into the CBD. Once the whole of T-limb was inside, the tie was cut, and the T-tube would spring into place. Choledochotomy was sutured snugly around the T-tube. The long limb was taken out through the lateral port of the abdominal wall.ResultsThere was no dislodgment or removal difficulty in all cases. This manoeuvre required <1 minute.ConclusionsThis technique allows reliable and easier T-tube placement into CBD, requiring no ancillary devices. It shortens the steep learning curve.SynopsisLaparoscopic placement of T-tube in CBD can be safely and easily manipulated in the described technique.

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